Answering Your Coronavirus Questions: Global Health, Small Businesses, Silver Linings

May 26, 2020
Originally published on May 26, 2020 11:01 pm

On this broadcast of The National Conversation, we'll answer your questions about how the coronavirus is affecting health around the world. An emergency physician will talk about what scientists have learned in the last 10 weeks about the virus and what researchers do and don't know. We'll also hear some of your stories about silver linings found in the pandemic.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

ARI SHAPIRO, HOST:

This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. And each night we're here to answer your questions.

KAREN: Hi, my name is Karen (ph). And I'm calling from California.

MIKE: Hi, this is Mike (ph) in Tucson, Ariz.

UNIDENTIFIED PERSON #1: I am a restaurant owner in Portland, Ore., and I recently purchased my business from another owner.

JARED: My question is regarding the cloth face masks that are so popular these days.

KAREN: My question is, how is the coronavirus affecting the Native American population in the United States?

TAYLOR: Do banks, big banks in particular, have to follow a set of rules or guidelines when lending their paycheck protection loans?

UNIDENTIFIED PERSON #2: How long are asymptomatic carriers of COVID-19 contagious?

UNIDENTIFIED PERSON #3: Thank you.

UNIDENTIFIED PERSON #4: Have a good night.

ARI SHAPIRO: Tonight we have experts on hand to offer solid facts, tell you what we know and correct some of the misinformation that's floating around. And when we don't know something, we will tell you that, too. This is our last week answering questions on THE NATIONAL CONVERSATION, at least for the time being. So for the next few days, you can still send us your questions about the pandemic and the way we live now at npr.org/nationalconversation. On Twitter, use the hashtag #NPRConversation. Each night we begin by answering the question, what happened today?

The floor of the New York Stock Exchange opened for the first time since the pandemic began.

(CHEERING)

ARI SHAPIRO: Stocks surged and ended the day up. Biotech company Novavax began human trials of its coronavirus vaccine in Australia this week. The WHO reports it is the 10th vaccine to begin human trials. Deaths in New York were down to their lowest point since tracking started. Governor Andrew Cuomo said we grieve the lives lost but have hope as the death toll steadily drops.

(SOUNDBITE OF ARCHIVED RECORDING)

ANDREW CUOMO: Maybe we don't all run back to the beach, but we're going to turn the page on COVID-19.

ARI SHAPIRO: The Democratic governor of North Carolina is responding to the president's Twitter threats to pull the Republican National Convention out of Charlotte. Governor Roy Cooper says the state is still waiting on a safety plan from Republicans for their August convention.

(SOUNDBITE OF ARCHIVED RECORDING)

ROY COOPER: I'm not surprised by anything that I see on Twitter. I will say that it's OK for political conventions to be political, but pandemic response cannot be.

ARI SHAPIRO: The president says he wants a decision from the governor in a week on whether they'll be able to have the full convention or not.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT DONALD TRUMP: Now if he can't do it, if he feels that he's not going to do it, all he has to do is tell us. And then we'll have to pick another location. And I will tell you, a lot of locations want it.

ARI SHAPIRO: In the U.S. there have been nearly 100,000 deaths from COVID-19. Worldwide, more than 5 1/2 million cases have been identified, and the actual total is almost certainly far higher than that. To help us understand how the disease is affecting the world, NPR's Pien Huang joins us again. She covers global health and development. Good to have you back.

PIEN HUANG, BYLINE: Hi. Great to be here, Ari.

ARI SHAPIRO: Let's start with the relationship between the U.S. and the international community. Last week, President Trump sent a letter to the World Health Organization saying the U.S. may leave the agency because of the WHO's handling of COVID-19. What's been the fallout from that announcement?

HUANG: Yeah, you're right. So last week, President Trump sent a letter to the head of WHO criticizing the response to the COVID-19 pandemic. And his main issue in the letter is that WHO lacks independence from China. So far, WHO hasn't said a whole lot in response. They basically said we've received the letter, and we're looking into it. Now, it would be a big deal if the U.S. cut funding and left the World Health Organization. But global health experts point out that it's not really the president's decision to make. Moves like that would have to be approved by Congress. But they say that the letter is still damaging because it's divisive, and it makes it really hard for the agency to focus on dealing with the global pandemic.

ARI SHAPIRO: Now, President Trump's reasoning focuses on China's lack of transparency when COVID-19 was beginning to spread. What do global health experts say about China's responsibility for the spread of the disease?

HUANG: So they've been telling me that there is evidence that China was not transparent early on in the outbreak. Some experts told me that Chinese health authorities were probably somewhere between two and six weeks late in sharing knowledge about the disease with the world. But they also told me that while it might be valid to say China maybe should have reported earlier, it's not quite as valid to say that it's WHO's fault because the organization is governed by its member countries. It's not designed to be independent from China or from the U.S. or from any of its member nations, really. So global health experts say that if we want WHO to actually hold countries accountable, it has to be structured differently.

ARI SHAPIRO: OK, let's get some listener questions here. A few people have asked us about how to interpret the global COVID-19 numbers. Here's one of them.

RICK ACKERMAN: I'm Rick Ackerman (ph) from San Diego, Calif. I listen to NPR, and I hear the statistics for the coronavirus for the various countries in the total numbers. But without knowing the populations of the countries, it's difficult to make sense. I would really like to know what the infection rate is in the population per hundred-thousand.

ARI SHAPIRO: It's a great question, not just the total number of infections, where we know the U.S. is in the lead, but about the infection rate. What does Rick's way of looking at the numbers show us?

HUANG: Yeah, so Rick's instinct to look at numbers in the context of their population size is a good one. And when you actually look at the number of confirmed cases per capita, the U.S. comes in 10th. We have about 500 confirmed cases per 100,000 people. Now, the thing that you might not expect is that very small countries tend to dominate this list. So the top three countries are San Marino, Qatar and the Vatican. And Qatar is the largest of those countries. It has 3 million people.

So I spoke with a couple of researchers about comparing per capita rates. And what they told me is that it's actually very hard to compare between countries. Each one has a different testing strategy, and every country is at a different stage in their epidemics. So it doesn't really make for an apples to apples comparison, but it might be more useful when you're looking inside a country. So, for instance, China is very low on the per capita list because their population's huge. But definitely, some of their cities have had high infection rates, so it might be more useful to compare the per capita infection rates of Wuhan and New York, say, instead of China and the United States.

ARI SHAPIRO: Interesting. All right, Bette (ph) in Colorado has another question about global COVID-19 numbers.

BETTE: I look at the world map every morning in the newspaper, and it appears that the coronavirus has been very active in selected areas around the globe. Places where the virus has traveled are diverse. Detroit, Mich., and a small village in the Brazilian rainforest are examples of this. And yet, other places, like heavily populated areas in East Africa, appear to be only minimally affected. How can this be so random, or is it?

ARI SHAPIRO: Yeah, Pien, can you explain why the virus has spread in such inconsistent ways in different parts of the world?

HUANG: Yeah, it's something that a lot of public health researchers are asking. Why are some places hit really hard and others not as much? And if we take the example of Africa that Bette brought up, the situation in most countries there is much less severe than WHO officials were projecting just a month or two ago. And they think that in the case of Africa, it has to do with a couple of factors. So the disease came later to the African region than it did to the U.S. or to Europe, and so physical distancing and travel bans when they were put in place, they came relatively early in their outbreaks. And another reason could be that Africa has a very young population. There's - 60% of the people there are under 25. And young people tend to not get as sick from COVID.

So WHO officials are cautiously optimistic, but they are also warning that it could just be early days in the epidemic there. The disease could still take off. So they're saying it's a time to be vigilant. And while they are optimistic about the situation, they're still on edge.

ARI SHAPIRO: That's really interesting and shows how quickly our understanding of this disease is changing. Our next listener question is also about Brazil, which has the second highest number of COVID-19 cases in the world.

MARINA: Hi, my name is Marina (ph). I'm calling from Twentynine Palms, Calif. And I heard on NPR the devastating impact that the coronavirus is having in Manaus, Brazil, which is, like, one of the most steamy, hot, tropical places you can think of. What does that say about the theory that the virus can't survive in a hot, humid environment?

ARI SHAPIRO: Yeah, so many people have been asking whether the virus is going to die down in the summer in the United States. Does Manaus disprove that theory?

HUANG: Well, as Marina said, Brazil is currently the world's No. 2 hot spot for coronavirus. It has around 375,000 confirmed cases. And its second only to the U.S. And the lack of testing in Brazil probably means that there's a lot more. But Marina's question is about seasonality and whether public health officials expect the virus to naturally dip in summer months. And what WHO was saying is that right now, no, they don't expect to see that because it's a new disease, and everyone in the world is pretty susceptible to it. So they expect to see it continue to spread regardless of temperature and season.

Now, if COVID-19 sticks around for a long time, we might in the future start seeing cycles of the disease in different seasons, depending on how many people are immune to the virus and how people behave in different times of year. But for now, the virus hasn't gone away naturally in any countries. And places that have managed to suppress it have done it through a lot of hard work and strong public health measures.

ARI SHAPIRO: OK, our next question comes from a listener named Brian (ph) in Idaho.

BRIAN: Are there any statistics on the rate of infection in the millions of refugee people in refugee camps and the morbidity rate? Thank you very much.

ARI SHAPIRO: That's a great question. I mean, we're in one of the largest numbers of displaced people in modern history right now. And refugee camps are so densely populated. What can you tell us about how the disease is being spread in these camps?

HUANG: Unfortunately, we don't actually have a lot of information right now about what's happening in refugee camps. As you mentioned, people living in these camps are often living in very crowded conditions without good access to toilets and running water. And there have been efforts in some camps to test. There have been, so far, two dozen cases found now at a Rohingya refugee camp in Bangladesh. And now 15,000 people there are quarantined. And camps are trying to do what they can to prepare for the virus. So they're stepping up hand-washing stations. They're handing out masks. But statistics on infections and COVID-related deaths among migrants are really hard to come by and even harder now that the work of many humanitarian groups that are usually in these camps have been put on hold.

ARI SHAPIRO: That is NPR's Pien Huang, who covers global health and development for NPR. We really appreciate your answering all these listener questions for us.

HUANG: Thanks for having me, Ari.

ARI SHAPIRO: And we know that the way we work is going to change dramatically as a result of this pandemic. So if you have questions about the future of work, we want to help. Go to npr.org/nationalconversation. On Twitter, use the hashtag #NPRConversation. Or you can call and leave us a voicemail message at 202-403-0386. Once again, that number is 202-403-0386. In just a moment, we'll look into how our understanding of COVID-19 has changed over the past few months. You're listening to THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

(SOUNDBITE OF MAC MILLER SONG, "SELF CARE")

ARI SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. Since we started this program 10 weeks ago, a lot has changed. Scientists know much more about COVID-19, but there's still a lot that we don't know, like why some patients respond to the disease differently and how long the coronavirus will be with us.

Dr. Megan Ranney is an emergency physician at Brown University and Lifespan Health Systems in Rhode Island. And she's here to answer your questions about what we do and don't know about the coronavirus right now. Thanks for joining us again, Dr. Ranney.

MEGAN RANNEY: Thank you, Ari. It's a pleasure to be here.

ARI SHAPIRO: You know, it's been two months since you first talked to us on this program. So to begin with, I'm just curious, so much has changed since then, what are you seeing in your area?

RANNEY: Yeah, two months feels like so long and yet so little time. Here in Rhode Island, we are seeing the number of new cases plateau. But we are still seeing a lot of really sick patients. Our hospital is certainly open for business. And again, we're not seeing those huge waves of patients that we saw a couple of months ago. But it is still amongst us. And we are still having patients come in who are very, very ill.

ARI SHAPIRO: OK, so some good news, but not out of the woods yet. Let's get to these listener questions, starting with Peter (ph) in Connecticut.

PETER: There's uncertainty whether a recovery from COVID-19 leads to immunity, and if it does, what sort of immunity. Can't conclusions be drawn from the people who've already recovered from COVID-19?

ARI SHAPIRO: So whether COVID-19 recovery leads to immunity, is that something that scientists do or don't know?

RANNEY: (Laughter) We both do and don't.

ARI SHAPIRO: (Laughter).

RANNEY: We certainly are studying - I know, right? This is going to be my answer for a lot of things, I think.

ARI SHAPIRO: (Laughter) OK.

RANNEY: But we're studying people that have recovered. And we find that they have antibodies. And they seem to be resistant to getting infected again. But we don't know how long that lasts, right? We don't know if this is going to be like the common cold, where you have immunity for a month or two, or if it's going to be like something like measles or smallpox, where you get immunity for years or for your entire lifetime.

ARI SHAPIRO: OK. Our next listener question is about a vaccine. This is from Nicole (ph) in Dallas, Texas.

NICOLE: My question is about the admittedly optimistic vaccine timeline. We've been hearing 12 to 18 months for five or six months. So my question is whether that means 12 to 18 months from January, which means more like 12 months now, or are we talking about a year and a half from today?

ARI SHAPIRO: That's a good point. Twelve to 18 months has been the refrain for a while now. What is the timeline at this point?

RANNEY: So it all depends on a little bit of luck. It could be only 12 months from now. There have been a couple of really promising studies, one of which is now out in the scientific literature, which is progressing - the way that vaccines work, there are various stages of trials. And those promising early trials are now leading to the next phase. So if those continue to show good results, we may have vaccines that are ready for distribution as early as this winter, which would be awesome - so January, 12 months from when we first started giving that estimate.

But if anything goes wrong, if those vaccines aren't safe or if they don't actually confer immunity or if there are problems with manufacturing, we could be looking at much longer. So 12 months - December, January - is an optimistic timeline. And we're all keeping our fingers crossed.

ARI SHAPIRO: OK, depends on a lot of variables then. Well, speaking of the vaccine, from the beginning of this program, we've been getting a lot of questions about whether the virus is likely to mutate. Wendy (ph) in Nevada wants to know about that.

WENDY: Does the coronavirus that causes COVID-19 mutate like the flu virus? If so, could the COVID-19 vaccine in development now be ineffective next year?

ARI SHAPIRO: Do scientists have a good answer to this question?

RANNEY: So far it looks like it does not mutate like the flu virus does. It looks like it stays relatively stable. And there are little teeny mutations, but they aren't ones that change immunity or that would change the efficacy of a vaccine. That said, we are only four months - well, five months now - into this epidemic, right?

ARI SHAPIRO: Yeah.

RANNEY: And so we're still watching. It may change. But as of right now, it seems pretty stable, which is good news.

ARI SHAPIRO: Yeah, that is good news. OK, this next question is about the arc of the disease. And it comes from Gail (ph) in Wisconsin.

GAIL: I would like to understand more about the stages of the disease's progression. What are the survival rates for each stage? How is critical defined? When does it become clear if someone in critical condition will survive or not?

ARI SHAPIRO: Dr. Ranney, walk us through this from infection to conclusion. What have doctors learned about the way this disease runs its course?

RANNEY: Do you have an hour, Ari?

(LAUGHTER)

ARI SHAPIRO: We're going to blow through all the other segments. Just take the rest of the hour to answer this one question, no.

RANNEY: Seriously, though, so we are both - we've learned a lot, but there's still a lot we don't know. We know that when people get infected, most people get symptoms within about 14 days. Some don't ever get symptoms. Of those who do get sick, who get a cough and a fever and all those other symptoms that we're looking out for, a small portion of them progress to get sicker - to get pneumonias or to get some of the other related syndromes that we're noticing from COVID-19. Of those, a portion need to be hospitalized. And of those, a portion get really, really sick and have to be in the intensive care unit, get critically ill.

The survival rates at each stage depend on so many factors. They depend on what preexisting conditions you have. They depend on ways that we're still trying to figure out about how the virus affects your blood and your oxygen level, your lungs, your brain, your kidneys. There are folks that are starting to create scores to help us predict survival and to predict the need for hospitalization, but that's an area that we're still doing a lot of research on.

The big takeaway is that it takes about two weeks from when you get infected to get symptoms. And then it's usually another one to two weeks after that before people get sick enough for hospitalization. But we're finding that some people keep having symptoms for, like, a month or a month and a half, two months, which is crazy and is unusual.

ARI SHAPIRO: We've talked to some of those people on this program about the really long road to recovery. I'm struck by the fact that when we started this program, people were being told not to wear masks in public. And that's one of the big things that has changed. Our next question about masks is from Jared (ph) in Salt Lake City.

JARED: My question is regarding the cloth face masks that are so popular these days. It's my understanding that the cloth face masks really don't do a whole lot as far as stopping viruses from entering or leaving your body. Are they really that helpful?

ARI SHAPIRO: Dr. Ranney, what's the latest research show on masks?

RANNEY: So this is a place where scientists will say a mea culpa. We did say early on don't bother to wear masks. But then we started to get some data that those cloth masks may actually make a difference. And the ones that make a difference are the ones that are made with more than one layer of fabric. So if you use two layers, they're more effective. And then there are certain types of fabric that seem to be more effective than others. A tighter weave of cotton or silk both seem to be more effective. And there are some good studies out.

They're certainly not as good as those surgical masks that we wear in the hospital setting. But, of course, as you know, we still have shortages of protective equipment for frontline health care workers. So for now, the data is that wearing those good cloth masks decreases transmission to other people and also likely protects you from getting infected if you're in close contact with a person who's sick. But the best protection, of course, is still that physical distancing.

ARI SHAPIRO: Dr. Megan Ranney of Brown University, thank you so much for answering all of these questions for us tonight. It's been great having you on the program.

RANNEY: Thank you, Ari. Thanks for doing this. Really appreciate it on behalf of our country.

ARI SHAPIRO: Oh, thank you so much. Well, this week - later this week on THE NATIONAL CONVERSATION, some churches, mosques and synagogues are reopening. What are the decisions that you're making when it comes to safely practicing your faith? Go to npr.org/nationalconversation. On Twitter, use the hashtag #NPRConversation. Or you can call and leave us a message at 202-403-0386. Once again, that number is 202-403-0386. Coming up later in the hour, what are the silver linings of this pandemic experience we've all been living through? Stay with us. This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

ARI SHAPIRO: It's THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. As our show wraps up this week, we'll hear some of your stories about silver linings during this pandemic.

UNIDENTIFIED PERSON #5: People are now waving. They used to just ignore me, not ever say a word, never wave. Now everybody waves.

ARI SHAPIRO: How some things have changed for the better after these headlines.

(SOUNDBITE OF MUSIC)

ARI SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. Small businesses have struggled to keep going through shelter-in-place orders. And as states reopen, it's not always clear how to keep employees and customers safe. Nearly three months into this crisis, many of you have told us you are trying to figure out how to keep your own businesses' doors open. Joining us to answer your questions about small businesses, we have NPR political and economics reporter Danielle Kurtzleben. Good to have you back, Danielle.

DANIELLE KURTZLEBEN, BYLINE: Yeah, good to talk to you, Ari.

ARI SHAPIRO: And we also have two small business owners joining us on the line tonight. First, I want to introduce Tony Davis. He owns Million Year Picnic, a comic shop in Cambridge, Mass. I'm told it's the oldest comic shop in New England. Is that right, Tony?

TONY DAVIS: Yes, Ari. We're actually one of the three or four oldest in the country at this point.

ARI SHAPIRO: Incredible. Well, what has a typical day at work been like for you during this pandemic?

DAVIS: You know, we had already started transitioning to doing more curbside service even before the shutdown of nonessential businesses. And essentially, the rules in the state of Massachusetts have only allowed me as the owner for almost two months to be on the premises of the store, to be inside the store for the purposes of doing e-commerce. So I have two employees, one in his late 60s, one in his mid to late 70s, who automatically, they just should not have been out and went into sheltering in place.

ARI SHAPIRO: Right. They're high risk, sure.

DAVIS: So of the five-person operation, really, I've been the only person making and receiving orders, doing deliveries. We went to doing free home deliveries and also packing and shipping stuff for mail orders.

ARI SHAPIRO: Wow. And have you been - I was just going to ask if you'd been able to access local or federal funds to help you keep the - I don't know - tires rolling.

DAVIS: We have applications out there for funding. I'm going to learn about some applications I put in in about mid-June. But basically, we've been trying to get by making a fraction of what we normally make. And for a five-person operation, it's been basically reduced to one person in the shop and my right-hand woman Kelly (ph) giving me some support in terms of social media and computer work.

ARI SHAPIRO: Wow. That sounds like a lot. I want to bring in another small business owner. Mary Domito is the owner of Mattress Mary, with three stores in New Mexico and Colorado. Mary, thank you for joining us.

MARY DOMITO: Oh, thank you, Ari. It's a pleasure to be here with you.

ARI SHAPIRO: During this crisis, did you ever wonder whether you would be able to keep your business afloat?

DOMITO: Oh, absolutely. I have run the gamut. I would say five to six weeks ago, I was on the phone with a bankruptcy attorney exploring all our options. But here we are five, six weeks later, and there is light at the end of the tunnel that I see. So I'm happy to be able to say that.

ARI SHAPIRO: What is that light at the end of the tunnel? What does it look like?

DOMITO: Well, it's sort of been in phases, Ari. It started with receiving our PPP loan a month ago.

ARI SHAPIRO: That's the Payment Protection Program, right.

DOMITO: Yes, the payroll protection program for our 12 employees. And that's made a difference. So May 1, they all came back to work. We were closed from March 16 until May 16, so eight weeks we were closed and for a couple of weeks had the employees on payroll and took advantage of that time, even though we weren't open yet, to take care of housekeeping - company housekeeping issues that normally we just run out of time to take care of. So I saw that as an opportunity. And a couple of weeks ago, my SBA EIDL loan - disaster loan - came in. And that has been huge.

ARI SHAPIRO: That's great. I want to bring in our in-house expert Danielle Kurtzleben and ask, Danielle, do these two stories that we're hearing fit in with what you've heard from other small businesses about their ability to access government support and other resources?

KURTZLEBEN: Yeah. I mean, you have a variety of small business loans - or of small businesses out there and what sorts of programs they decide or don't decide to take. I'm not sure if Tony Davis there decided to apply for PPP. You do have a bunch of businesses that just decide that some of these programs aren't for them. Now, just at the very start of the PPP program, the Paycheck Protection Program - again, the one that a lot of our listeners have heard about - when it first opened in early April, yeah, it was hard for a lot of small businesses to get that money. There was a mad rush. Some people just didn't even get applications in. Now we have a second pot of money. It has calmed down.

And I've heard from some businesses who have said, you know, I've still had a bit of trouble. I'm waiting for the money. There are people like Mary here who have gotten the money, and it's been a success for them. And you have some other businesses that say, listen; the program is not clear enough. I don't feel comfortable taking this money. It won't work for me. So it's a program that has been successful for some, not for others.

ARI SHAPIRO: I'm curious what the future looks like for each of you. Mary Domito, you said that there seems to be a light at the end of the tunnel. Tony Davis, for you, what do you think the future holds?

DAVIS: Well, we've been doing a lot of creative things. One of my customers is actually teaching an online comics creating course for 8 to 14-year-olds. We did that successfully in March and April and May.

ARI SHAPIRO: That's great.

DAVIS: We're going to continue to do that through the summer since parents won't have camps available to them in a lot of places, doing more and more online business, but at the same time, trying to figure out how to safely do curbside again, how to safely, at some point, bring customers back into the store. But I still feel like there isn't enough testing, and we don't really want to see a huge resurgence. I don't want to put my customers and I certainly don't want to put my staff in jeopardy.

ARI SHAPIRO: Sure. And Mary, do you think your business is going to look different six months from now than it did before this all began?

DOMITO: Well, in some way, absolutely. To Tony's point, we've reopened. My stores, of which there are three, average between eight and 10,000 square feet. And we're only allowing two couples in the store at a time. After a second couple comes in, we lock the door. We have signs on the door advising them to sit in front of the store until it opens up again. So this ensures that our staff can give really good service and that it's safe as can be. And of course, we're all wearing masks and keeping a physical distance as well. And traffic's been good. We've been open a week now. And we are seeing customers. And we are running business. And so I'm feeling extremely optimistic, although, you know, this 2 months has been a real reality check for me in terms of making sure that we can handle anything. I'm anticipating slower business, so...

ARI SHAPIRO: Well, I'm glad that you're both feeling optimistic and that you're both seeing a hopeful future. Mary Domito, owner of Mattress Mary's in New Mexico and Colorado, Tony Davis, owner of the comic shop Million Year Picnic in Massachusetts, thank you both for sharing your stories and experiences with us. And good luck.

DAVIS: Thank you so much, Ari.

DOMITO: Thank you, Ari.

ARI SHAPIRO: And, Danielle Kurtzleben, before we have to take a short break, I'm just curious in what you heard from both of them, kind of light at the end of the tunnel, if it sounds like what you're hearing from other small businesses across the country right now.

KURTZLEBEN: Yeah. I mean, I'm hearing a lot of things from them that other business owners will tell you, which is they're being creative with how they are getting money in the door, with what they're doing with what little, sometimes, money they're getting in the door. And also, yeah, if - when, in some of the cases with these loans, sometimes they have to bring people back to work but don't necessarily have things for them to do. So they find things - repainting, training, that sort of thing. So yeah, a lot of similarities there.

ARI SHAPIRO: All right, we're going to take a short break. NPR's Danielle Kurtzleben, stay with us. If you have questions, go to npr.org/nationalconversation. Or you can ask them on Twitter with the hashtag #NPRConversation. We'll be back in a moment.

(SOUNDBITE OF STACEY KENT SONG, "NEVER LET ME GO")

ARI SHAPIRO: ...WITH ALL THINGS CONSIDERED from NPR News. And NPR's Danielle Kurtzleben is still with us. Let's take some other listener questions about small businesses. Taylor (ph) in California had trouble getting his government PPP loan for his small business at first. That's been resolved, but he still has this question.

TAYLOR: Do banks, big banks in particular, have to follow a set of rules or guidelines when lending their paycheck protection loans? Or as many speculate, are they cherry picking clients and the loans that they want to provide to first?

ARI SHAPIRO: Interesting. Danielle, are they able to pick and choose who they want to loan to?

KURTZLEBEN: That's a great question. And the answer is somewhere in the middle. To some degree, yeah. So listen; there are definitely rules. And the SBA, Small Business Administration, upfront said the program is supposed to be first come, first served. But the banks are essentially middlemen here. And so they are allowed to do a few things within that. For example, many took their existing customers first. Now, those bankers will tell you, well, of course, we want to preserve our customer relationships. But if you're a small business without a firm banking relationship, that kind of shut you out. The deck was stacked against you at first. So that definitely happened. Now, in terms of things that look less ethical than that, there are stories out there. For example, the New York Times earlier on reported that JPMorgan Chase gave a sort of white glove treatment to bigger businesses. And you also have some lawsuits out there alleging that big banks were picking bigger clients because they wanted bigger fees because beyond a certain level, the bigger the loan, the bigger the fee. So...

ARI SHAPIRO: Right, of course.

KURTZLEBEN: ...Big banks - yeah - big banks do deny this, I should say. So we're going to see how those lawsuits play out.

ARI SHAPIRO: OK, we got this next question from a listener about federal small business loans.

MIKE: Hi. This is Mike in Tucson, Ariz. The just-released PPP loan forgiveness application does not require any information regard to business income generated during the loan period. This seems to be ripe for fraud by firms who may have generated enough income to get their loan forgiven simply by showing they met payroll. How are the feds going to determine whether firms actually needed forgiveness if they don't ask for income statements?

ARI SHAPIRO: Danielle, how's the federal government handling this?

KURTZLEBEN: Well, there are a few ways. One is that for loans over $2 million, so the very biggest loans - and there are still quite a few of those - the SBA has said they will be giving those extra scrutiny. So those places with the biggest loans, they can probably expect some audits. Now, if I'm understanding the question correctly here about whether you had a particular income during the loan period, that doesn't really necessarily disqualify you. But it is true that when you apply for that PPP loan, you do have to certify on the form that you needed the loan. And while those smaller loans aren't getting that special scrutiny, I asked some accountants about this today. And what one of them told me was, look; we don't have 100% clarity on how forgiveness will work. So, yeah, what he's telling his clients is, first of all, there are only a few categories of things you can spend the money on. So yes, follow the rules, and spend the money on those few things, including payroll. But aside from that, what he's told his clients is, look; if you think you don't really need the money, maybe don't get the paycheck protection loan. You could run the risk of fines, legal action down the road. So the SBA does reserve the right to come after you later, for some reason, if they think that something shady is going on.

ARI SHAPIRO: All right, NPR politics and economics correspondent Danielle Kurtzleben, thank you for answering all these questions for us.

KURTZLEBEN: Yeah. Thank you.

ARI SHAPIRO: And if you've got questions, we want to help. Go to npr.org/nationalconversation. On Twitter, use the hashtag #NPRConversation. Or call and leave us a message at 202-403-0386. Once again, that number is 202-403-0386. You're listening to THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News.

(SOUNDBITE OF KAYTRANADA FEAT. KARRIEM RIGGINS AND RIVER TIBER'S "BUS RIDE")

ARI SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED. I'm Ari Shapiro. The pandemic has left many Americans struggling financially, physically and emotionally. But some of you tell us that you have found silver linings in our new reality. You've told us about moments of happiness and asked questions about how to find it during these tough times. So we're happy to welcome back Dr. Amelia Aldao, a clinical psychologist in New York City who specializes in treatment for anxiety. Dr. Aldao, thanks for being here.

AMELIA ALDAO: Yeah, thank you so much for having me.

ARI SHAPIRO: Before we start talking about moments of joy in a pandemic, I want to acknowledge that this makes many people feel guilty, you know? When people are sick and dying and out of work, what do you tell your patients about looking for the silver lining and focusing on the joy?

ALDAO: Yeah, absolutely. So, you know, I think more than ever this is a time for all of us to try to focus on the silver linings, on the positive moments, the positive relationships, also the opportunities for growth. And like you're saying, this usually comes with some feelings of guilt. And, you know, we tend to have a very complex relationship with guilt. Guilt is an emotion that signals that other people are not doing well - right? - that other people are having difficulties. And it makes us very uncomfortable. So we tend to try to push it away. Or we actually end up getting sucked into it.

What I tell my patients all the time, what I tell my friends - quite frankly, what I tell myself - is, you know, to acknowledge the guilt and to try to turn it into something positive. How can you turn your guilt into helping other people, into connecting with others more?

ARI SHAPIRO: Yeah. Well, let's hear from our first listener about one of these silver linings that they've found.

AMBICA: Hello, my name is Ambica (ph). I live in Berkeley, Calif. And one of my neighbors has every night with her two kids put on this concert for all of her neighbors. It's a singalong. We all join in. They take requests. And it's such an act of love for the community, building something intangible but that really brings us all together.

ARI SHAPIRO: I love that. Dr. Aldao, a lot of listeners have shared stories about neighborly kindness. Do you think this pandemic is reshaping the way we interact with people around us?

ALDAO: Yes, absolutely. And I love the stories, too. You know, as you mentioned, I live in New York City. This is a place where we don't talk to our neighbors very much. We're constantly running. We don't know where, but we're always running somewhere, right? And I noticed that in the past few weeks, people are talking more to their neighbors. I'm talking more to my neighbors. I'm getting to know them better.

And very quickly, yesterday I was walking around my neighborhood. And I saw about seven or eight people. They were on the sidewalk with a table, balloons, a cake. They were practicing social distancing. And they were celebrating a birthday. And as I walked they started talking to me and telling me about the birthday celebration they were having. And I had a moment, and I was like, this is not a New York that I recognize. You know, we're changing a lot how we are connecting with other people.

ARI SHAPIRO: That's great. Let's listen to this next story from Katie (ph), who wanted to share something she witnessed while waiting in line at the store.

KATIE: The woman in front of me at the line gave the cash register person $20 for each person in the line after me to use towards our groceries. So I think she gave him $100. It was really amazing. And I was in that, like, fearful place. And then I just turned to her, and I was like, oh, my God. Thank you so much. And she said, we really have to take care of each other during this time. And I just totally started crying. It just really touched me. Everybody in the store was kind of thinking of themselves, and here was this wonderful woman that was able to get outside of the fear. And survival makes us all want to think of ourselves, and it's an important thing to do, and we're taking care of families. But how evolved it was for me to witness this wonderful woman step outside of that fear-based consciousness and into this wonderful neighborly act, it was just extremely touching.

ARI SHAPIRO: Dr. Aldao, I love Katie's framing of this story as stepping outside of that fear-based consciousness. As a psychologist, how do you view this story?

ALDAO: Yeah. I mean, as a psychologist, as a person, it's really giving me goosebumps, to be honest. You know, and basically, you know, I work a lot with anxious clients. And, you know, anxiety is - it's an emotion that makes us retreat. It makes us hide. It makes us sort of protect ourselves and close off to others. But sometimes some people respond to anxiety in a different way. They actually open themselves up. They actually go out of their way to connect with others and, like in this case, to be generous.

So what I would say, you know, to the listeners of the show is, you know, I know that when we're feeling anxious and stressed we want to hide. We want to run away. And that's going to be the default answer, the default response in many ways. But maybe every now and then, you can actually take that opposite action. And when you have fear, when you're anxious, maybe you open yourself up and help your neighbor, you know? Or help somebody else, or just simply ask somebody how they're doing. And I think that can go a long way, not only in terms of helping other people, but also in terms of helping you manage your anxiety a lot better, you know, standing up to it, facing it and crushing it, really.

ARI SHAPIRO: Clinical psychologist Amelia Aldao, thank you so much for joining us for this moment of joy in the middle of the pandemic. We appreciate it.

ALDAO: Thank you for having me.

ARI SHAPIRO: And before we close, the staff on our show wanted to share ways that they are finding joy right now.

JEFF PIERRE, BYLINE: Hey, this is Jeff Pierre - "The Last Dance" on ESPN.

CAROLINE KELLY, BYLINE: Caroline Kelly - possum Instagram accounts.

BARRY HARDIMAN, BYLINE: Barry Hardiman - rereading a bunch of Regency romance, like Georgette Heyer's books.

WILL JARVIS, BYLINE: Will Jarvis. What's bringing me joy is I finally got around to watching "The Sopranos" and learned how to properly say gabagool.

SURAYA MOHAMED, BYLINE: Suraya Mohamed. Every Thursday, my son tells me he's going to the club. It's really just a live DJ set on Instagram. It makes me smile. And it gives me hope that one day we'll all be able to get out and dance and be together in the same space again.

MONIKA EVSTATIEVA, BYLINE: Monika Evstatieva - long hikes through the forest.

ASHLEY WESTERMAN, BYLINE: Ashley Westerman - making a s'more using the microwave.

LAUREN MIGAKI, BYLINE: Lauren Migaki. As one of the few folks still coming into the office, my co-worker gifted me the Girl Scout cookies that she'd left behind. Thanks, Hannah (ph).

CASEY MORELL, BYLINE: I'm Casey Morell - the return of live soccer. That and alcohol.

SIMONE POPPERL, BYLINE: Simone Popperl - watching the plants in our garden grow what feels like a foot a day at this point.

JAMES WILLETTS, BYLINE: I'm James Willetts. And I've got a little boy turning 1 bringing me lots of joy, toddling around the house and engaging us with all kinds of smiles and laughter.

ERIC MARRAPODI, BYLINE: This is Eric Marrapodi. And my joy is those brief and rare moments of quiet.

DAVE BLANCHARD, BYLINE: This is Dave Blanchard. And what's bringing me joy is games of Cribbage with my family.

MIA VENKAT, BYLINE: Hi, this is Mia Venkat. And my mom drove up to D.C. to drop off a bunch of home-cooked Indian meals for me. And I was so happy because I'd been home alone in D.C. for two months. And I am tired of cooking for myself.

CLAIRE LOMBARDO, BYLINE: Claire Lombardo - a fresh jar of Nutella sitting in my pantry.

ARI SHAPIRO: I'm Ari Shapiro. And what's been giving me joy is that my garden is producing way more greens than I can handle, so I've been giving bags and bags of them to my elderly neighbors, saving them from having to go to the supermarket. My co-host Michel Martin will be here tomorrow to answer more of your questions. Send them to us at npr.org/nationalconversation. On Twitter, use the hashtag #NPRConversation. Or call and leave us a message at 202-403-0386. Again, that number is 202-403-0386. We've got three days left to answer your questions, so send them in.

(SOUNDBITE OF VULFPECK'S "TEST DRIVE (INSTRUMENTAL)")

ARI SHAPIRO: This is THE NATIONAL CONVERSATION WITH ALL THINGS CONSIDERED from NPR News. Transcript provided by NPR, Copyright NPR.